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(1) The "Fecal-Sewer-Aerosol" transmission theory:

Yesterday, I reported my discovery that #COVID19 transmission seems to follow river watersheds where cities have large Combined Sewer Overflow (CSO) discharges (Milan, London and New York v. Tokyo).

(2) We also know the viable #COVID19 is present in the stool samples of infected individuals.
(3) A key piece of the puzzle was brought to me by @Nordstern12.

researchgate.net/publication/31…
(4) So during an outbreak #coronavirus is present in our sewer systems and can be entrained in sewer gases that can contaminate bathrooms, due to poor P-, S- or U-traps or via toilet plumes.

This is the "fecal-sewer-aerosol" vector.
(5) There is a famous SARS-CoV-1 Super-Spreader case where this mechanism was identified as the problem in an old apartment building. Sewer gases in one unit contaminated many others through the ventilation system.
(6) If you're in a city with a Combined Sewer/Stormwater System, the #coronavirus contaminated sewer water and gas may also be discharging into your neighborhood waterways.

(7) Contagious aerosols may be released as gas or created at the spillway end of the discharge pipe.
(8) Combined Sewer Overflows are a second vector of "Fecal-Sewer-Aerosol" transmission.

Because of sewer gas odors Tier 1 discharges are concentrated in poorer neighbors, sparing wealthier people of rainy day sewer odors.
(9) #COVID19 infested micro-feces may form a film on open waters near CSO discharges.

Contaminated water may coat shores & provide a vector for oral transmission through hand-to-mouth contact.

They may also form aerosols at downstream spillways.

circleofblue.org/2020/world/vir…
(10) Additional details can be found in yesterday's research thread.

(11) Credits and references

diagnosticsolutionslab.com
@Nordstern12
nyc.gov
@nytimes

researchgate.net/publication/31…
(12) The Toshiba Clean Wash BIdet
(13) The history of "washlets" in Japan
Courtesy of @wikiwand.

wikiwand.com/en/Electronic_…
(14) The "washlet" in action. Does the flush cycle minimize plume?

upload.wikimedia.org/wikipedia/comm…
(15) Could high tech Washlets and Separate Sewer and Storm Water Systems have prevented "Fecal-Sewer-Aerosol" transmission in Japan?

Was this significant factor in their success?
(16) Just curious.
(17) The Toto Washlet, widely used in Japan, features an automatic, water-saving dual-flushing, system that ensures the lid is closed and minimizes toilet plume.
(18) Of course Toilet Plume can expose bathrooms and their users to virus laden sewer gases and their entrained particulates.
JSD doesn't like the name Fecal-Sewer-Aerosol Transmission.

I'd switch to another if you have a good idea.

How about these, or reply with your own:
Fecal-Sewer-Aerosol Transmission (FeSAT) or (FeSewAerT)?

Fugitive Sewer Gas Releases (FSGR)?

Fecal-Aerosol-Respiratory-Transmission (FART)?
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Magilla Gorilla 39
@39Magilla
(1) Yesterday, I noticed that the #COVID19 outbreak in Italy seemed to be contained to the Po river watershed.

Today, I thought I'd look at watersheds around NYC, to see if they could explain the large variations between outcomes within the city

(2) Conventional wisdom has explained the stark variation in outcomes between boroughs as being affluence related, but is it?

Brooklyn & Queens are split geographically into high and low infection zones.

The Bronx is hit very hard, but it doesn't cross the Harlem river.
(3) This "watershed" map shows relationships between regions that may not be apparent to everyone. Manhattan and west Brooklyn share a watershed.

Could watersheds play a role in viral transmission?
Read 38 tweets
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Magilla Gorilla 39
@39Magilla
(1) Six Regions of Italy were hard hit, but Rome and Naples were largely spared.
(2) Exposed to the Adriatic, but blocked in by Mountains to the North, East and South: The Po River Watershed.
(3) Could the spread of the virus be related to a river watershed?

Based on current theories of transmission we wouldn't expect that, other than a river creating a wind current perhaps.

What about the fecal-oral route?
Read 9 tweets
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Magilla Gorilla 39
@39Magilla
(1) Initial State Ro Values from @youyanggu model correlate moderately with State Population Densities. ImageImage
(2) One of the most important properties for any infectious disease is the basic reproduction number, known as Ro. Rather than pre-setting this value based on assumptions, the @youyanggu model is able to learn the value that most closely matches the data. Image
(3) For the United States, New York had the highest initial Ro value; New Jersey was second. Other states had much lower initial Ro values including Arkansas, Mississippi and Montana. Image
Read 11 tweets

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